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Home My WebLink AboutCEMEX PAPERWORK55518187 SCANNED BY St. Lurie County .Arrtve `Job t-' : _Start Unload �Y I Sfi Unload 'Retprn , .«Fir: i 5<'LeaveJOb 1$ Plant' w 092/ 10 '2 Customer Code: Customer Name: Customer Job Number. Order Code/Date: .314910E EMPORIUM HOMES CORP 1065 05/30/1. Project Code: Project Name:- ' - I Project P.O. Number 1 Order P.O: Number. NO PO Ticket Data: Delivery Address: / Map Page: Map/Row/Column: 05/30/13 760E FORT WALTON AVE y/ 273 27328024 Delivery Instruction:" - - Dispatcher. LAKEWOOD PARK SMWilliamson I-95 NORTH TO INDRIO 'EAST' TO EMERSON NORTH, TO- LAKELAND BLVD Ticket Number. EAST TO -FORT PIERCE BLVD'SOUTH-TO FORT'WAL'TON'EAST TO JOB 32619562 7ue On Job: Slump: Truck Number. DriverNumber: Driver Name: Entl Use: 11:15 5.c_0 10023215 109220E JOHNNY SIMPSON BLDNG• SLAB LOAD CUMULATIVE ORDERED MATERIAL CODE QUANTITY QUANTITY QUANTITY PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT 10.O6 10.00 29,00 1152536 22500 REG YB3 7.50 7.50 .75 13826)0 FIBERMESH 150 L$ a 'a` 00 I Cash Check# Check =-1224781;B FUEL SURCHARGE 1202749 ENVIRONMENTAL CHARGE of Driver Did you do —your circle of sa%W7 Did you identify hazards?' Did you use your coqgies ,Nhen at,pur.M? Did you use your sntery cones? to Did you,colrlrnt I14'te unaefe aond' dispatch1other drivers? tAA4 30 AMIO:4?. RECEIVED MAY 3J?013 i a. Cash Received: to Collect WATER ADDED:GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: SIGNATURE 0 LOAD WAS TESTED BY: _ Notice: Our drivers will make every effort to place materials where the customer designates, out the SPECIAL TERMS: Any water atltletl I5 al customers own risk. I er Is added on lob, concrete strew' Company assumes no responsibility for damages Inside curb or property me. Customer agrees to the is net onger guaranteed. WARNING: Product may cause antl/or eye Imitation. CAUTION: MC terms of sale and delivery and accepts concrete as is. Due to Important factors which are out of our may be hazardous to your safety and health. P refer to the backsitle of this ticket for in' control after delivery, This Company will not accept any responsibility for the finished results. No credit forsafety handling informadon, and to them fety data sheets for additional information. returned concrete. buyers exceptions and claims shall be deemed waived unless made to us in writing AUTRORr[ED SIGNATURE: within one business day after the receipt of materials. A. 68UNIVERSAL PREV TRK: .ORIGINAL LOAD 55518189 SCANNED BY St. LurieCouniv 092/1 Customer Code: Customer Name: 3149106 EMPORIUM HOMES CORP Customer Job Number. Order Code l Dale: Protect Code: ' Protect Nam1065 05/30/1: e: ... = i ; r -• � • Project P.O. Number. Order P.O. Number. Ticket Date: Delivery Address `/ NO PO 05/30/ 13 760E FORT WALTON AVE ia� Map Page: Map/Row/Column: .r Delivery Instructions 273 27328024 LAKEWOOD PARK Dispatcher. SMWitll, ams.on I-95 'NORTH TO"INDRIO 'EAST TO EMERSw NORTH' TO LAKELAND�'BLVD Ticket Number. ` EAST TO FORT'RIE•RCE J3LVD -SOUTH TO FORT WALTON EAST TO'JOB 32 619635 ]ue On Job: Slump: Truck Number. Driver Number: Driver Name: Entl Use: 11:37 5.<_0 100257 4 1092291 ANGEL DELATORRE BLDNG SLAB uw Nve ORDERED QUANTITY QUANTITY QUANTITY MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRILE AMOUNT 10. 00 2C�, 00 29' 00 115253E 2500 REG YD3 7.50 15.0o .73 13826,00 FIBERMESH 150 LS 1.00 Cash Check Check MAY 30 Amli:W . I.24781,8 FUEL SURCHARGE um .1202749 ENVIRONMENTAL CHARGE of Driver Receiving Cash: V Cash Received: Total COD Order Amounito Collect Without Standby Charges: Uid you do your circle LIT 3121111 r Did you identify hazards? Did you use your goggles when at pump? Did you use your safoty cones? Did you communicate unsafe Con ions to dispatch/other drivers? WATER ADDED: ZL. GAL YARDS INDRU WHEN ADDED. CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: SIGNATURE ❑ LOAD WAS TESTED BY: Notice: Our tlrtvere will make every effort to place materials where the customer designates, but the SPECIAL TERMS: Any water added is at customers awn risk. If water is added on Job, concrete strength Company assumes no responsibility for damages insitle curb or properly line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye irritation. CAUTION: Material terms of sale end delivery and accepts roncrete as Is. Due to Important fatlare which are out of our may be hazardous to your safety and health Please refer to the backside of this ticket for important ronbol after delivery, this Company will not accept any responsibility for Ne Onished results. No credit for safety andling inform anal safety data sheets for additional information. resumed concrete. Buyers exceptions and claims shall be deemed waived unless matle to us In writing ALITHO AT RE: within one business day after the receipt o1 materials. 68UNIVERSAL PREV TRK: 10023215 LOAD NUN: 2 I "1 -55518192 6LANNED BY St Lucie County low"IaD1�� - .:_- �.,:.-._� „x,,.: ,'.: ._ '` . gplvs�fob�r ...'�tart,L"nt`IS� x FJn7§�l;l'1hIoS+s?s*?�eaY�:°JoheR ��Ete Wr`n�P.lan"1 •- 092/10 2 .Customer Cade: Customer Name: 3149106 EMPORIUM HOMES CORP - .... ,. . Project Code -4:7no so Name:;. - _ - Ticket Data: Delivery Address: 05/30/13 7606 FORT WALTON AVE DellverYlnshucfions Customer Job Number. Order Code / Data: 1065 05/3o/1 Projectls.O.Ntbrb r Ober P.03Number. NO PO Map Page: MapRimv/Column. 273 27328024 . . _ DlsPatdhec . SMWl1I1dUison NORTH `TO LAKELAND'ZLVD nhdatNember. 2T YWALfeN - EASTr TO' .30B 32619812 Due On Job: Slump: 12:27 5. Truck Number 0 10026018 Driver Number 1092o2 Driver Name: RAY MORRIS End Use: BLDNG: SLAH LOAD CUMULATIVE I ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT QUANTITY I QUANTITY QUANTITY 9 02'" 09' 00 29.'06 1452536 2500 RES YD3 6 75 21.75 ``75 ix 8c£00 EIBERr4ESH 150 Y30PM12:04 1247B18 FUEL SU HnR 1 00'•s:t ell is2D2749 ENVIRONMENTAL CHARGE t ii `' ✓web k. ,U .+' 0, w" gg Cash Check ft I Auth Coda: Signature of-0dver Receiving Cesh: Cash Recelved:, TotaI COD Order Amount to Collect Check Without Standby Charges; Did you identify hazards? Did you uSp your goggles when at pump? Did you use your safety Co Did you communicate un e c di to dispatch/other drivers? WATER ADDED: .GAL YARDS IN DRUM: WHEN ADDED. SIGNATURE CURB LINE CROSSED AT OWNER'S/AGENT'S REQUEST: SIGNATURE -- pp -- 7ASTtEbIt.,C .J Notice: Our drivers will make every effort to place matedaa /L. Ne customer designates, but the SPECIALTERMS: Any wets ddad la et eustomen: own Oak. If water is added on job, concrete strength Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the Is ho longer guaranteed. NG: Product may reuae skin andror eye Irritation. CAUTION: Materiel terms of sale and delivery and accepts concrete as Is. Due to Important factors which ere out of our may be hazardous to f an health. Please refer to the backside of this ticket for Important control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handling Inform n to the matelot salary data sheets for additional Information. returned concrete. Buyers exceptions and claims shell be deemed waived unless made to us In writing AUTHORIZED SIG within one businass day after the recelpt of materials. 68UNIVERSAL PREV TRK: 10025754 ORIGINAL /� LOAD NUM: 3